Hypertension and COVID-19: Updates from the era of vaccines and variants

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathogen responsible for coronavirus disease 2019 (COVID-19) has been a major cause of morbidity and mortality globally. Older age, and the presence of certain components of metabolic syndrome, including hypertension have been associated with increased risk for severe disease and death in COVID-19 patients. The role of antihypertensive agents in the pathogenesis of COVID-19 has been extensively studied since the onset of the pandemic. This review discusses the potential pathophysiologic interactions between hypertension and COVID-19 and provides an up-to-date information on the implications of newly emerging SARS-CoV-2 variants, and vaccines on patients with hypertension.

Impact of the COVID-19 Pandemic on Cardiovascular Health in 2020

“…There also remain significant uncertainty and controversy regarding angiotensin-converting enzyme 2–mediated SARS-CoV-2 cell entry, infection, and COVID-19 and the roles played by key moieties in the renin-angiotensin-aldosterone system, especially in patients with hypertension, hypertensive heart disease, and heart failure. 39 , 40 , 41 , 42 Mechanistic clinical investigations and prospective, controlled clinical studies of an appropriate sample size would be invaluable in shedding more light on the observed increased mortality in patients with IHD and hypertension.…”

Diabetes and COVID-19: Short- and Long-Term Consequences

“…1-7 and represents the vasoprotective, anti-inflammatory and anti-fibrotic component of the angiotensin renin system [reviewed in [39,40]). It is still a matter of debate whether upregulation of ACE2 is beneficial for COVID-19 prognosis or not [39].…”

“…SARS-CoV-2 replication is initiated by binding of the viral spike (S) protein to the surface receptor ACE2 of the host cell (reviewed in 39 ). ACE2 catalyzes conversion of Angiotensin II into Angiotensin 1–7 and represents the vasoprotective, anti-inflammatory and antifibrotic component of the angiotensin renin system [reviewed in 39 40 ). It is still a matter of debate whether upregulation of ACE2 is beneficial for COVID-19 prognosis or not 39 .…”

Obesity and COVID-19: What are the Consequences?

“…ACE2 also cleaves angiotensin I to angiotensin 1–9, which can be further converted to angiotensin 1–7 by ACE 29 . ACE2, Ang-(1–7), and its mitochondrial assembly (Mas) receptor constitute the vasoprotective arm of the RAAS leading to anti-inflammatory and anti-fibrotic responses 29 32 33 34 .…”